MEDICAL GROUP OF INDIANA LLC – Rheumatology Physician, NPI 1306334255
Rheumatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MEDICAL GROUP OF INDIANA LLC
3620 W Bethel Ave
Muncie, IN 473045407
Phone: (765) 717-5399
Type: Location
3550, West Fox Ridge Lane, Andersonville, Muncie, Delaware County, Indiana, 47304, United States
MUNCIE, IN 473045205
Phone: (765) 717-5399
Type: Mailing
330 N Wabash Ave
Marion, IN 469522696
Phone: (765) 717-5399
Type: Location
2226 W Alto Rd
Kokomo, IN 469024840
Phone: (765) 717-5399
Type: Location
813 N Lincoln St
Greensburg, IN 472401330
Phone: (765) 717-5399
Type: Location
2451 Intelliplex Dr Ste 250
Shelbyville, IN 461768581
Phone: (765) 717-5399
Type: Location
1007 N 16th St
New Castle, IN 473624320
Phone: (765) 717-5399
Type: Location
900 Sim Hodgin Pkwy
Richmond, IN 473741932
Phone: (765) 717-5399
Type: Location
2705 S Berkley Rd Ste 4D
Kokomo, IN 469028007
Phone: (765) 717-5399
Type: Location
1107 S TILLOTSON AVE
MUNCIE, IN 473044517
Phone: (765) 717-5399
Type: Mailing
3620 W BETHEL AVE
MUNCIE, IN 473045407
Phone: (765) 717-5399
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-11-09
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-11-30 (928 days ago).
Enrollment records
1
Earliest due date
2023-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20181109000451 | O | Clinic/Group Practice | IN | 2023-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 47304)
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